K R Rachakonda1, A Nugur2, N A Shekar3, B Kidiyur1, P Kilaru4, S Gannamani4, V M Joseph5. 1. Trauma and Arthroplasty and Foot and Ankle Surgeon, Sunshine Hospitals, Secunderabad, India. 2. Trauma Surgeon, Sunshine Hospitals, Secunderabad, India. 3. Department of Orthopaedics, Sunshine Hospitals, Secunderabad, 500003, India. 4. Trauma and Arthroplasty Surgeon, Sunshine Hospitals, Secunderabad, India. 5. Department of Orthopaedics, Sunshine Hospitals, Secunderabad, 500003, India. dr.vinayjoseph@gmail.com.
Abstract
INTRODUCTION: Studies have demonstrated a decrease in the incidence of late consequences and the socio-economic burden of intra-articular fractures of calcaneum when treated by surgical fixation. Operative management of displaced intra-articular calcaneal fractures (DIACF) pose significant challenges such as technical difficulty, wound healing and long-term pain and disability. MATERIALS AND METHODS: All patients presenting to the ER with DIACF over a period of 2 years and matching the inclusion criteria were enrolled in the study. Percutaneous fixation with 4 mm CC screw was undertaken with a minimally invasive sinus tarsi approach. All patients were available for a minimum follow-up of 24 months. Six radiological parameters were assessed, and functional outcome was evaluated using AOFAS score. RESULTS: Thirty-four patients with 42 calcaneal fractures were included in the study, and all patients were available for minimum follow-up period. All radiological parameters were attained within anatomic normal range and maintained at 24 months of follow-up. AOFAS score showed a mean value of 90.10 which is considered an excellent outcome. Superficial wound infection was seen in two patients, but no patients required a revision surgery. CONCLUSION: Displaced intra-articular fractures pose a treatment dilemma, more so in cases of soft tissue complications like open injury or blisters. Percutaneous screw fixation with limited sinus tarsi incision has shown good functional and radiological outcome with minimal complications and can be undertaken without delay.
INTRODUCTION: Studies have demonstrated a decrease in the incidence of late consequences and the socio-economic burden of intra-articular fractures of calcaneum when treated by surgical fixation. Operative management of displaced intra-articular calcaneal fractures (DIACF) pose significant challenges such as technical difficulty, wound healing and long-term pain and disability. MATERIALS AND METHODS: All patients presenting to the ER with DIACF over a period of 2 years and matching the inclusion criteria were enrolled in the study. Percutaneous fixation with 4 mm CC screw was undertaken with a minimally invasive sinus tarsi approach. All patients were available for a minimum follow-up of 24 months. Six radiological parameters were assessed, and functional outcome was evaluated using AOFAS score. RESULTS: Thirty-four patients with 42 calcaneal fractures were included in the study, and all patients were available for minimum follow-up period. All radiological parameters were attained within anatomic normal range and maintained at 24 months of follow-up. AOFAS score showed a mean value of 90.10 which is considered an excellent outcome. Superficial wound infection was seen in two patients, but no patients required a revision surgery. CONCLUSION: Displaced intra-articular fractures pose a treatment dilemma, more so in cases of soft tissue complications like open injury or blisters. Percutaneous screw fixation with limited sinus tarsi incision has shown good functional and radiological outcome with minimal complications and can be undertaken without delay.
Entities:
Keywords:
Displaced intra-articular calcaneal fracture; Minimally invasive fixation; Sander’s type 2; Sander’s type 3; Sinus tarsi approach
Authors: Richard Buckley; Suzanne Tough; Robert McCormack; Graham Pate; Ross Leighton; Dave Petrie; Robert Galpin Journal: J Bone Joint Surg Am Date: 2002-10 Impact factor: 5.284